Poor healthcare plagues Bangladesh ready-made garment sector

Four months into her pregnancy, Tahmina, 35, found herself under constant stress as she tried to meet the production quota in the RMG factory in Tejgaon where she had been working for the last four years.

She saw that the working conditions were quite unfavourable to her current condition.

“The work we do demands constant physical activity and if we fail to meet the quota, we are held accountable by the higher authority,” she told The Daily Star recently.

Recalling an incident, she said, “One of the elevators is always shut off. If the other one breaks down, we are required to use the staircase,” she said.

Tahmina is expecting her second child after 12 years, and is under constant fear of losing her job. The Tk 7,500 that she earns supplements the finances for her dual-income household of which her husband earns another Tk 8,000.
“There is a constant struggle to balance my pregnancy and work. I can't complain, though, as this limited salaried job has given me an opportunity to earn and support my family.”

However, the nature of her job takes a toll on her health. She has to stand for long hours at work. In another instance of poor working conditions, once Tahmina asked for a stool to sit and although she was provided one, it was very low and she struggled to reach the table while sitting, hampering her work.

Tahmina also gets an hour-long for her lunch but she isn't allowed to eat any meal in the factory as per the company's rule. This often forces her to leave the factory premises and look for other places to have lunch.

Compounding her problems are the issues of maternity leave and pay, along with healthcare issues.

“We get 112 days of paid maternity leave. Of that, 40 days are reserved for before childbirth.”

The labour law in Bangladesh specifies a 16-week maternity leave with full pay.

However, a study by Manusher Jonno Foundation (MJF) in 2018 found that only 28.70 percent of the workers get maternity leave for four months. This is further exacerbated by the fact that 71.30 percent of the workers believe the leave is actually for lesser than four months.

In terms of maternity pay, Tahmina feels a lot more can be done.

She has been told that she would be paid maternity leave dues when she rejoins work. “Obviously, it would have helped if I had the money in hand at the moment as there are growing expenses. But this is how it is.”

However, the procedure of payment is to pay eight weeks' salary within three days of submitting proof of pregnancy with the remaining amount provided after the submission of proof of delivery within three working days.

The other option is to pay the entire 16 weeks' salary within 3 days of proof of delivery.

The recently proposed Bangladesh Labour Law entitles workers to eight-week maternity leave and other benefits within three days of submission of necessary documents.

According to the draft, an owner may face a penalty of Tk 25,000 if they do not abide by these rules.

Siddiqur Rahman, president of the Bangladesh Garment Manufacturers and Exporters Association (BGMEA), said as per the practice in factories, the eight weeks' advance salary would be given before going on leave and the remaining salary would be given after rejoining.

In some cases, workers have also been sacked and indirectly requested to come back after giving birth to the child.

State Minister for Labour and Employment Mujibul Haque Chunnu said it was mandatory for every factory to provide paid maternity leave as it was a right.

HEALTH WOES REMAIN
Right after the birth of a child, the new mother has to join the factory within a couple of months, hampering their postnatal care.

Tahmina recently came under the care of Dr Subrina, chief medical officer of Awaj Foundation, an organisation which provides free health care facilities to RMG workers and their children and raises awareness on their rights and responsibilities.

Subrina said that rejoining work two months after childbirth was harmful for both the mother and the child. The mother is compelled to work for long hours, thus being unable to take care of or even breastfeed her child.

A baseline survey by the SNV Netherlands Development Organisation in 2015 reported that 59.7 percent of female RMG workers responded that they were not aware of the need for postnatal care, while 55.6 percent workers reported that they delivered their child at home.

Most expecting female workers go to their hometown for childbirth, after being influenced by their elderly relatives, Subrina said, adding many women wait too long and choose to not go for C-sections, even if needed.

Another issue is the lack of medical facilities and the long hours workers are expected to work.

Despite the presence of a medical officer in her factory, Tahmina says that this is more convenient for her to visit Awaj Foundation.

“The medical officer sits on a lower floor, and I have to go downstairs to visit her. This takes time and affects my productivity, and in turn will affect my evaluation,” she said.

Her story is similar to those of many others.

Ruby, 22, can't visit government hospitals because of her long working hours and she can't afford the visitation fees of a private institute.

Her 10-hour workday means she has to set out for work by 7:00am and work the long shift, with only an hour's break. By the time she is done, she is too tired and the doctors are too far away for her to go for check-ups.

“We need to stay at work for a long period of time, and so it is impossible to see an external healthcare provider after work,” she says.

The healthcare centre in her factory is kept open six days a week and for eight hours a day, and mostly provides primary healthcare to the garments workers.

“During weekends, after work or even during any emergency, we go to a pharmacy near our house and seek treatment from the employees there,” said Ruby.

Ruby said that she goes to a pharmacy for medical help even when her son falls ill.

“I cannot take my son to hospitals in the morning [because of the working hours], and there are no healthcare centres near our home.”

Ahmmed from BILS suggested to The Daily Star that the government and factory owners could take up the initiative to establish hospitals or clinics in the areas where garments workers live within the industrial zone and provide facilities.

OF THE MONETARY AND MENTALITY
But even if such facilities are provided, there are still some ingrained practices that need changing.

20-year-old Hashi often has to face problems during her menstrual cycle while she is on duty. Her male supervisor does not allow her to go to the toilet frequently.

She said the only toilet in her factory floor was shared by about 200 female workers and was not well-maintained.

Hashi also told The Daily Star that it was difficult for her to even afford one sanitary napkin, a problem all too familiar for many other women in the country.

On this issue, Dr Subrina said that because of lack of proper menstrual hygiene, most of the garments workers complain of vaginal infections or suffer from urinary tract infection (UTI) and other ailments.

In the SNV survey, it was found that 72.6 percent of the respondents reported to having used cloths, rags or other materials during menstruation.

The main driver of the growth, garments exports has become a sector that a nation can be proud of but, they need to also be proud of the people working to develop the industry, Taslima Akhter, president of Bangladesh Garment Sromik Samhati, said.

She further said to make the workforce productive, garment factory owners, international clients, and the government should increase their wages and provide free hospital facilities so the workers could be healthy as well as productive.